Charles Anthony Benincasa, PSYD

Primary specialty

PsychologistTaxonomy code 103T00000X

License

PY.61155333 Issued in WA

Practice address

1728 W Marine View Dr Ste 109
Everett, WA 98201-2094

Phone

(425) 285-8353

Fax

(888) 240-5967

NPI assigned

Oct 4, 2019

Last updated

Dec 29, 2021By the provider in NPPES

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in WA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Psychologist

Education

Other, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Bill Heusler PSYD PLLCGroup PAC ID 2264722123, 12 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Bill Heusler, PSYD, PLLC

  dba Spectrum Psychological Associates

  • Clinical Psychologist
  • Everett, WA
  • NPI 1538409271

  Mental Health

  Medicare reassignment Care Compare group NPD
• Program for the Advancement of Trauma Healing

  • Psychologist
  • Everett, WA
  • NPI 1538018429
  NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1570147200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1640736000000",
    "number": "1922649557",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1728 W MARINE VIEW DR STE 109",
            "city": "EVERETT",
            "state": "WA",
            "postal_code": "982012094",
            "telephone_number": "425-285-8353",
            "fax_number": "888-240-5967"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1728 W MARINE VIEW DR STE 109",
            "city": "EVERETT",
            "state": "WA",
            "postal_code": "982012094",
            "telephone_number": "425-285-8353",
            "fax_number": "888-240-5967"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BENINCASA",
        "first_name": "CHARLES",
        "middle_name": "ANTHONY",
        "name_prefix": "Dr.",
        "credential": "PSYD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-10-04",
        "last_updated": "2021-12-29",
        "certification_date": "2021-12-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "WA",
            "license": "PY.61155333",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Dianna Benbow, B.A, RBT
• Brooklyn Carson Bender
• Sara Bender
• Dorian Elizabeth Benedict
• Tobias Levi Bengston
• Amanda Benjelloun, ARNP
• Shelby A Benn
• Kristin Bennett, CO
• Lena Bennett
• Samantha Nicole Bennett, DPT

• Psychologist in Everett, WA
• Providers in Everett, WA by specialty
• Psychologist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 29, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.